· Spending for inpatient hospital services fell from 26% to 20% between 2009 and 2018. Spending on Medicare beneficiaries enrolled in managed care plans grew from 23% to 32% over the same period; and enrollment in Medicare managed care increased 82% between 2010 and 2018.

· Medicare spending per beneficiary has fallen from average annual rates of 10% in the 1980s to 2% between 2010 and 2018. Despite the slowdown, growth in total spending is projected by the Trustees and the Congressional Budget Office to average 8% annually, compared to about 4% projected by the GDP.